The Ear Your Ears Are in Charge of Collecting Sounds, Processing Them
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Vestibular Neuritis, Labyrinthitis, and a Few Comments Regarding Sudden Sensorineural Hearing Loss Marcello Cherchi
Vestibular neuritis, labyrinthitis, and a few comments regarding sudden sensorineural hearing loss Marcello Cherchi §1: What are these diseases, how are they related, and what is their cause? §1.1: What is vestibular neuritis? Vestibular neuritis, also called vestibular neuronitis, was originally described by Margaret Ruth Dix and Charles Skinner Hallpike in 1952 (Dix and Hallpike 1952). It is currently suspected to be an inflammatory-mediated insult (damage) to the balance-related nerve (vestibular nerve) between the ear and the brain that manifests with abrupt-onset, severe dizziness that lasts days to weeks, and occasionally recurs. Although vestibular neuritis is usually regarded as a process affecting the vestibular nerve itself, damage restricted to the vestibule (balance components of the inner ear) would manifest clinically in a similar way, and might be termed “vestibulitis,” although that term is seldom applied (Izraeli, Rachmel et al. 1989). Thus, distinguishing between “vestibular neuritis” (inflammation of the vestibular nerve) and “vestibulitis” (inflammation of the balance-related components of the inner ear) would be difficult. §1.2: What is labyrinthitis? Labyrinthitis is currently suspected to be due to an inflammatory-mediated insult (damage) to both the “hearing component” (the cochlea) and the “balance component” (the semicircular canals and otolith organs) of the inner ear (labyrinth) itself. Labyrinthitis is sometimes also termed “vertigo with sudden hearing loss” (Pogson, Taylor et al. 2016, Kim, Choi et al. 2018) – and we will discuss sudden hearing loss further in a moment. Labyrinthitis usually manifests with severe dizziness (similar to vestibular neuritis) accompanied by ear symptoms on one side (typically hearing loss and tinnitus). -
Inner Ear Infection (Otitis Interna) in Dogs
Hurricane Harvey Client Education Kit Inner Ear Infection (Otitis Interna) in Dogs My dog has just been diagnosed with an inner ear infection. What is this? Inflammation of the inner ear is called otitis interna, and it is most often caused by an infection. The infectious agent is most commonly bacterial, although yeast and fungus can also be implicated in an inner ear infection. If your dog has ear mites in the external ear canal, this can ultimately cause a problem in the inner ear and pose a greater risk for a bacterial infection. Similarly, inner ear infections may develop if disease exists in one ear canal or when a benign polyp is growing from the middle ear. A foreign object, such as grass seed, may also set the stage for bacterial infection in the inner ear. Are some dogs more susceptible to inner ear infection? Dogs with long, heavy ears seem to be predisposed to chronic ear infections that ultimately lead to otitis interna. Spaniel breeds, such as the Cocker spaniel, and hound breeds, such as the bloodhound and basset hound, are the most commonly affected breeds. Regardless of breed, any dog with a chronic ear infection that is difficult to control may develop otitis interna if the eardrum (tympanic membrane) is damaged as it allows bacteria to migrate down into the inner ear. "Dogs with long, heavy ears seem to bepredisposed to chronic ear infections that ultimately lead to otitis interna." Excessively vigorous cleaning of an infected external ear canal can sometimes cause otitis interna. Some ear cleansers are irritating to the middle and inner ear and can cause signs of otitis interna if the eardrum is damaged and allows some of the solution to penetrate too deeply. -
CONGENITAL MALFORMATIONS of the INNER EAR Malformaciones Congénitas Del Oído Interno
topic review CONGENITAL MALFORMATIONS OF THE INNER EAR Malformaciones congénitas del oído interno. Revisión de tema Laura Vanessa Ramírez Pedroza1 Hernán Darío Cano Riaño2 Federico Guillermo Lubinus Badillo2 Summary Key words (MeSH) There are a great variety of congenital malformations that can affect the inner ear, Ear with a diversity of physiopathologies, involved altered structures and age of symptom Ear, inner onset. Therefore, it is important to know and identify these alterations opportunely Hearing loss Vestibule, labyrinth to lower the risks of all the complications, being of great importance, among others, Cochlea the alterations in language development and social interactions. Magnetic resonance imaging Resumen Existe una gran variedad de malformaciones congénitas que pueden afectar al Palabras clave (DeCS) oído interno, con distintas fisiopatologías, diferentes estructuras alteradas y edad Oído de aparición de los síntomas. Por lo anterior, es necesario conocer e identificar Oído interno dichas alteraciones, con el fin de actuar oportunamente y reducir el riesgo de las Pérdida auditiva Vestíbulo del laberinto complicaciones, entre otras —de gran importancia— las alteraciones en el área del Cóclea lenguaje y en el ámbito social. Imagen por resonancia magnética 1. Epidemiology • Hyperbilirubinemia Ear malformations occur in 1 in 10,000 or 20,000 • Respiratory distress from meconium aspiration cases (1). One in every 1,000 children has some degree • Craniofacial alterations (3) of sensorineural hearing impairment, with an average • Mechanical ventilation for more than five days age at diagnosis of 4.9 years. The prevalence of hearing • TORCH Syndrome (4) impairment in newborns with risk factors has been determined to be 9.52% (2). -
Tonic Tensor Tympani Syndrome (TTTS)
Tonic Tensor Tympani Syndrome (TTTS) http://www.dineenandwestcott.com.au/hyperacusis.php?fid=1 Retrieved 15ththth May 2009 In the middle ear, the tensor tympani muscle and the stapedial muscle contract to tighten the middle ear bones (the ossicles) as a reaction to loud, potentially damaging sound. This provides protection to the inner ear from these loud sounds. In many people with hyperacusis, an increased, involuntary activity can develop in the tensor tympani muscle in the middle ear as part of a protective and startle response to some sounds. This lowered reflex threshold for tensor tympani contraction is activated by the perception/anticipation of sudden, unexpected, loud sound, and is called tonic tensor tympani syndrome (TTTS). In some people with hyperacusis, it appears that the tensor tympani muscle can contract just by thinking about a loud sound. Following exposure to intolerable sounds, this heightened contraction of the tensor tympani muscle: • tightens the ear drum • stiffens the middle ear bones (ossicles) • can lead to irritability of the trigeminal nerve, which innervates the tensor tympani muscle; and to other nerves supplying the ear drum • can affect the airflow into the middle ear. The tensor tympani muscle functions in coordination with the tensor veli palatini muscle. When we yawn or swallow, these muscles work together to open the Eustachian tube. This keeps the ears healthy by clearing the middle ear of any accumulated fluid and allows the ears to “pop” by equalising pressure caused by altitude changes. TTTS can lead to a range of symptoms in and around the ear(s): ear pain; pain in the jaw joint and down the neck; a fluttering sensation in the ear; a sensation of fullness in the ear; burning/numbness/tingling in and around the ear; unsteadiness; distorted hearing. -
ANATOMY of EAR Basic Ear Anatomy
ANATOMY OF EAR Basic Ear Anatomy • Expected outcomes • To understand the hearing mechanism • To be able to identify the structures of the ear Development of Ear 1. Pinna develops from 1st & 2nd Branchial arch (Hillocks of His). Starts at 6 Weeks & is complete by 20 weeks. 2. E.A.M. develops from dorsal end of 1st branchial arch starting at 6-8 weeks and is complete by 28 weeks. 3. Middle Ear development —Malleus & Incus develop between 6-8 weeks from 1st & 2nd branchial arch. Branchial arches & Development of Ear Dev. contd---- • T.M at 28 weeks from all 3 germinal layers . • Foot plate of stapes develops from otic capsule b/w 6- 8 weeks. • Inner ear develops from otic capsule starting at 5 weeks & is complete by 25 weeks. • Development of external/middle/inner ear is independent of each other. Development of ear External Ear • It consists of - Pinna and External auditory meatus. Pinna • It is made up of fibro elastic cartilage covered by skin and connected to the surrounding parts by ligaments and muscles. • Various landmarks on the pinna are helix, antihelix, lobule, tragus, concha, scaphoid fossa and triangular fossa • Pinna has two surfaces i.e. medial or cranial surface and a lateral surface . • Cymba concha lies between crus helix and crus antihelix. It is an important landmark for mastoid antrum. Anatomy of external ear • Landmarks of pinna Anatomy of external ear • Bat-Ear is the most common congenital anomaly of pinna in which antihelix has not developed and excessive conchal cartilage is present. • Corrections of Pinna defects are done at 6 years of age. -
Auditory Nerve.Pdf
1 Sound waves from the auditory environment all combine in the ear canal to form a complex waveform. This waveform is deconstructed by the cochlea with respect to time, loudness, and frequency and neural signals representing these features are carried into the brain by the auditory nerve. It is thought that features of the sounds are processed centrally along parallel and hierarchical pathways where eventually percepts of the sounds are organized. 2 In mammals, the neural representation of acoustic information enters the brain by way of the auditory nerve. The auditory nerve terminates in the cochlear nucleus, and the cochlear nucleus in turn gives rise to multiple output projections that form separate but parallel limbs of the ascending auditory pathways. How the brain normally processes acoustic information will be heavily dependent upon the organization of auditory nerve input to the cochlear nucleus and on the nature of the different neural circuits that are established at this early stage. 3 This histology slide of a cat cochlea (right) illustrates the sensory receptors, the auditory nerve, and its target the cochlear nucleus. The orientation of the cut is illustrated by the pink line in the drawing of the cat head (left). We learned about the relationship between these structures by inserting a dye-filled micropipette into the auditory nerve and making small injections of the dye. After histological processing, stained single fibers were reconstruct back to their origin, and traced centrally to determine how they terminated in the brain. We will review the components of the nerve with respect to composition, innervation of the receptors, cell body morphology, myelination, and central terminations. -
Vestibular Neuritis and Labyrinthitis: Infections of the Inner
PO BOX 13305 · PORTLAND, OR 97213 · FAX: (503) 229-8064 · (800) 837-8428 · [email protected] · WWW.VESTIBULAR.ORG Vestibular Neuritis and Labyrinthitis Infections of the Inner Ear By Charlotte L. Shupert, PhD with contributions from Bridget Kulick, PT and the Vestibular Disorders Association Vestibular neuritis and labyrinthitis are Infections of the inner ear are usually disorders resulting from an infection that viral; less commonly, the cause is inflames the inner ear or the nerves bacterial. Such inner ear infections are connecting the inner ear to the brain. This not the same as middle ear infections, inflammation disrupts the transmission of which are the type of bacterial infections sensory information from the ear to the common in childhood affecting the area brain. Vertigo, dizziness, and difficulties around the eardrum. with balance, vision, or hearing may result. Inner ear structure and function The inner ear consists of a system of fluid-filled tubes and sacs (see diagram © Vestibular Disorders Association ◦ www.vestibular.org ◦ Page 1 of 6 on page 2) called the labyrinth. The Labyrinthitis (inflammation of the labyrinth serves two functions: hearing labyrinth) occurs when an infection and balance. affects both branches of the vestibulo- cochlear nerve, resulting in hearing The hearing function involves the cochlea, changes as well as dizziness or vertigo. a snail-shaped tube filled with fluid and sensitive nerve endings that transmit Bacterial and viral infections sound signals to the brain. Inner ear infections that cause vestibular neuritis or labyrinthitis are usually viral The balance function involves the rather than bacterial. Although the vestibular organs. Fluid and hair cells in symptoms of bacterial and viral infections the three loop-shaped semicircular canals may be similar, the treatments are very and the sac-shaped utricle and saccule different, so proper diagnosis by a provide the brain with information about physician is essential. -
Anatomy of the Ear ANATOMY & Glossary of Terms
Anatomy of the Ear ANATOMY & Glossary of Terms By Vestibular Disorders Association HEARING & ANATOMY BALANCE The human inner ear contains two divisions: the hearing (auditory) The human ear contains component—the cochlea, and a balance (vestibular) component—the two components: auditory peripheral vestibular system. Peripheral in this context refers to (cochlea) & balance a system that is outside of the central nervous system (brain and (vestibular). brainstem). The peripheral vestibular system sends information to the brain and brainstem. The vestibular system in each ear consists of a complex series of passageways and chambers within the bony skull. Within these ARTICLE passageways are tubes (semicircular canals), and sacs (a utricle and saccule), filled with a fluid called endolymph. Around the outside of the tubes and sacs is a different fluid called perilymph. Both of these fluids are of precise chemical compositions, and they are different. The mechanism that regulates the amount and composition of these fluids is 04 important to the proper functioning of the inner ear. Each of the semicircular canals is located in a different spatial plane. They are located at right angles to each other and to those in the ear on the opposite side of the head. At the base of each canal is a swelling DID THIS ARTICLE (ampulla) and within each ampulla is a sensory receptor (cupula). HELP YOU? MOVEMENT AND BALANCE SUPPORT VEDA @ VESTIBULAR.ORG With head movement in the plane or angle in which a canal is positioned, the endo-lymphatic fluid within that canal, because of inertia, lags behind. When this fluid lags behind, the sensory receptor within the canal is bent. -
Balance and Equilibrium, I: the Vestibule and Semicircular Canals
Anatomic Moment Balance and Equilibrium, I: The Vestibule and Semicircular Canals Joel D. Swartz, David L. Daniels, H. Ric Harnsberger, Katherine A. Shaffer, and Leighton Mark In this, our second temporal bone installment, The endolymphatic duct arises from the en- we will emphasize the vestibular portion of the dolymphatic sinus and passes through the ves- labyrinth, that relating to balance and equilib- tibular aqueduct of the osseous labyrinth to rium. Before proceeding, we must again remind emerge from an aperture along the posterior the reader of the basic structure of the labyrinth: surface of the petrous pyramid as the endolym- an inner membranous labyrinth (endolym- phatic sac. phatic) surrounded by an outer osseous laby- The utricle and saccule are together referred rinth with an interposed supportive perilym- to as the static labyrinth, because their function phatic labyrinth. We recommend perusal of the is to detect the position of the head relative to first installment before continuing if there are gravity (5–7). They each have a focal concen- any uncertainties in this regard. tration of sensory receptors (maculae) located The vestibule, the largest labyrinthine cavity, at right angles to each other and consisting of measures 4 to 6 mm maximal diameter (1–3) ciliated hair cells and tiny crystals of calcium (Figs 1–3). The medial wall of the vestibule is carbonate (otoliths) embedded in a gelatinous unique in that it contains two distinct depres- mass. These otoliths respond to gravitational sions (Fig 4). Posterosuperiorly lies the elliptical pull; therefore, changes in head position distort recess, where the utricle is anchored. -
Michigan Ear Institute Otosclerosis
Michigan Ear Institute Michigan Otosclerosis www.michiganear.com 34015-56111-109 BOOK Otosclerosis.indd 1 2/13/18 10:33 AM Dennis I. Bojrab, MD Seilesh C. Babu, MD John J. Zappia, MD, FACS Eric W. Sargent, MD, FACS DOCTORS Eleanor Y. Chan, MD Robert S. Hong, MD Ilka C. Naumann, MD Candice C. Colby, MD Christopher A. Schutt, MD Providence Medical Building 30055 Northwestern Highway Suite 101 Farmington Hills, MI 48334 Beaumont Medical Building LOCATIONS 3555 W. Thirteen Mile Road Suite N-210 Royal Oak, MI 48073 Oakwood Medical Building 18181 Oakwood Blvd. Suite 402 Dearborn, MI 48126 Providence Medical Center 26850 Providence Parkway Suite 130 Novi, MI 48374 248-865-4444 phone 248-865-6161 fax 1 34015-56111-109 BOOK Otosclerosis.indd 1 2/13/18 10:33 AM WELCOME Welcome to the Michigan Ear Institute, one of the nation’s leading surgical groups specializing in hearing, balance and facial nerve disorders. The Michigan Ear Institute is committed to providing you with the highest quality diagnostic and surgical treatment possible. Our highly experienced team of physicians, audiologists and clinical physiologists have established international reputations for their innovative diagnostic and surgical capabilities, and our modern, attractive facility has been designed with patient care and convenience as the foremost criteria. It is our privilege to be able to provide care for your medical problems and we will strive to make your visit to the Michigan Ear Institute a positive and rewarding experience. 3 34015-56111-109 BOOK Otosclerosis.indd 3 2/13/18 10:33 AM OTOSCLEROSIS Otosclerosis is a disease of the middle ear bones and sometimes the inner ear. -
Otosclerosis and Stapes Surgery | How to Prepare and What to Expect |
UW MEDICINE | PATIENT EDUCATION | | Otosclerosis and Stapes Surgery | How to prepare and what to expect | This handout explains otosclerosis, an ear problem that causes hearing loss. It also describes stapes surgery, which is done to improve hearing. What is otosclerosis? Otosclerosis (oh-toh-skleh-ROH-sis) is abnormal growth on the tiny stapes (stirrup) bone in your middle ear. This growth keeps the stapes from vibrating in response to sound. Otosclerosis is the most common cause of conductive hearing loss in adults. Conductive hearing loss is when sound waves cannot move normally in the ear (see DRAFTpage 3). At first, otosclerosis does not cause any symptoms. Hearing loss begins when the bone growth starts to affect how the stapes works. As the bone keeps growing, the Otosclerosis affects the stapes, a tiny hearing loss gets worse. bone in your middle ear. The good news is that hearing loss occurs in only 10% of people (10 out of 100) who have otosclerosis. Profound (severe) hearing loss and deafness are very rare. What causes otosclerosis? Otosclerosis can be hereditary, which means it may be passed from parents to their children. Someone in your family may have had the condition and passed it down to you. If you have otosclerosis, your children may inherit it. Hearing loss may not occur in all generations. The measles virus may affect whether or not you develop otosclerosis, but measles alone do not cause it. How is it treated? Your doctor may advise hearing aids or that you have stapes surgery to treat otosclerosis. Sometimes, both surgery and a hearing aid are needed. -
Vestibular Disorders Information | Fact Sheet
Sunshine Coast Hospital and Health Service Vestibular disorders information • BPPV is caused by blockage of one of the inner ear canals by small particles of debris. When the head is still, gravity causes the debris to clump and settle. When the head moves, the debris shift. This sends false signals to the brain, producing profound dizziness. • BPPV can often be treated by a series of specific movements to dislodge the particle and unblock the inner ear canal. Vestibular neuronitis/labyrinthitis • Vestibular neuronitis, a sudden onset of a constant, intense spinning sensation that is usually very disabling. Nausea, vomiting, unsteadiness while walking, and difficulty with vision are also common. What is it? • Labyrinthitis has the same symptoms as vestibular The vestibular system is located within the inner ear neuronitis but also affects the hearing apparatus, and contributes to our balance system and sense of leading to hearing loss or ringing in the ears moving in space. The vestibular system is important (tinnitus). for balance, coordination, and eye control. • They are both thought to be caused by viral infection Problems with the vestibular system can cause the which affects the vestibular or hearing nerve. following symptoms: • feeling of the room spinning (vertigo) Meniere’s disease • dizziness • nausea and/or vomiting • Causes recurrent attacks of spinning sensation, and • ringing in the ears nausea, fluctuating deafness, ringing or hissing in • difficulty with vision ears, fullness and pressure in ears. • loss of balance. • It is caused by a build-up of fluid inside the inner ear, which interrupts the signals of the nerves. Common types of vestibular disorders: Benign paroxysmal positional vertigo (BPPV) Stroke • While people are often concerned that their • BPPV is the most common disorder of the vestibular symptoms may be caused by a stroke, it is actually a system.